2020 2021 Towson University CCBC Essex

 
2020 2021 Towson University CCBC Essex
Towson University · CCBC Essex
                              Physician Assistant Program

                                     2020 - 2021
                                   Contents subject to change.

                              Mission Statement

 Our PA program educates and empowers resilient graduates to practice collaborative evidence-
            based medicine in the ever-changing diverse health care environment.

Revised 5/2020 Clinical Excellence Committee
2020 2021 Towson University CCBC Essex
Table of Contents
                                                                                                                                                  Page

Introduction .....................................................................................................................................     1
What to Expect From Clinical Rotations .........................................................................................                       2
     Objectives ................................................................................................................................       2
     Description of Sites ..................................................................................................................           2
     Preceptors ................................................................................................................................       2
     Schedule ...................................................................................................................................      3
     On-Site Faculty Evaluation ......................................................................................................                 3
Student Responsibilities ...................................................................................................................           3
     Starting a New Rotation ...........................................................................................................               3
     Attitude ....................................................................................................................................     4
     Representation .........................................................................................................................          4
     Dress Code ..............................................................................................................................         4
     Attendance ...............................................................................................................................        4
     Absences ..................................................................................................................................       5
     Religious Holidays ...................................................................................................................            5
     Illness ......................................................................................................................................    5
     Inclement Weather Policy.........................................................................................................                 5
Professional Conduct .......................................................................................................................           6
     Confidentiality .........................................................................................................................         7
     Problems ..................................................................................................................................       7
     Standards of Conduct ..............................................................................................................               7
     Probation ................................................................................................................................        8
     Academic and Clinical Dismissal .............................................................................................                     8
     Remediation .............................................................................................................................         9
     Deceleration ............................................................................................................................         9
     Academic Dismissal .................................................................................................................             10
     Professional Conduct (Disciplinary Dismissal) ........................................................................                           10
     Professional Conduct (Disciplinary) Dismissal Procedures......................................................                                   11
Rotation Requirements ....................................................................................................................            11
     Required Immunizations and Health Screenings ......................................................................                              11
     Site-Specific Paperwork ...........................................................................................................              12
     Personal Health Insurance Coverage/ Liability Insurance/Drug Screenings.............................                                             12
     Safety and Security ...................................................................................................................          12
     Injuries to Students on Clinical Site or Campus .......................................................................                          13
     Drug Screen, Alcohol Testing, and Background Check .............................................................                                 14
     Standard Precautionary Procedures.........................................................................................                       14

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2020 2021 Towson University CCBC Essex
Table of Contents (Continued)
                                                                                                                                                    Page

Graduation Eligibility /Requirements ..............................................................................................                     14
      Chart Entry Signature ..............................................................................................................              15
      Patient Encounter Logs ............................................................................................................               15
      Student Evaluation of the Clinical Rotation ..............................................................................                        16
Rotation/Course Grade Computation ...............................................................................................                       16
      Preceptor Evaluation ...............................................................................................................              16
      Mid-Rotation Evaluations ........................................................................................................                 17
      Post Rotation Examinations .....................................................................................................                  17
      Clinical Seminars .....................................................................................................................           17
      Grading Policy .........................................................................................................................          18
      Simulation Participant Assessments (OSCEs) ...........................................................................                            19
Clinical Practicum Objectives ..........................................................................................................                20
      Description ..............................................................................................................................        20
      Reading and Study ...................................................................................................................             20
      Goals .......................................................................................................................................     20
Community Medicine .......................................................................................................................              21
Emergency Medicine ........................................................................................................................             23
Family Medicine ..............................................................................................................................          25
Psychiatry Requirements For Family Medicine Rotations...............................................................                                    26
Internal Medicine ............................................................................................................................          28
Pediatric Medicine ...........................................................................................................................          30
Surgery .............................................................................................................................................   32
Women’s Health ..............................................................................................................................           34
Elective Rotation and Final Preceptorship ......................................................................................                        36
      Choosing a Rotation Site ..........................................................................................................               36
      General Elective ......................................................................................................................           36
      Final Preceptorship .................................................................................................................             36
      Student Responsibilities when Choosing a Rotation Site ...........................................................                                37
      Contacting Other PA Programs for Sites ..................................................................................                         38
Final Preceptorship Objectives ........................................................................................................                 38

Appendix
Faculty and Staff Information Sheet ..................................................................................................                  41
Holiday and Campus Activities .........................................................................................................                 42
Program Clinical Evaluation ............................................................................................................                43
Mid-Rotation Evaluation...................................................................................................................              48
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2020 2021 Towson University CCBC Essex
Table of Contents (Continued)
                                                                                                                                                  Page

Absence Form ...................................................................................................................................      49
Incident Report .................................................................................................................................     50
Letter of Intent ..................................................................................................................................   51
Physician Assistant Student Policy Agreement Clinical Year II .........................................................                               52
My Access Log-in..............................................................................................................................        53

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2020 2021 Towson University CCBC Essex
Towson University · CCBC Essex
                    Physician Assistant Program
                                          Introduction

                  Welcome to the Towson University CCBC Essex      ●

                           Physician Assistant Program
The clinical portion of the Physician Assistant Program begins in June of 2020 and extends through
May of 2021. The Final Preceptorship begins May 31, 2021, continuing to July 23, 2021 for a total of
8 weeks.

The subject matter in PA education can be very sensitive and sometimes upsetting in nature. Students are
reminded that the purpose of the educational sessions is to prepare students to provide physician
supervised primary health care to all persons and in all environments without regard to the student's own
personal beliefs and biases. The expectation is to practice compliant patient centered care in diverse
environments and areas of study.

Due to the high standards of our program, our students are advised to remain prepared and focused
throughout the entire curriculum. Because of the intensity of a graduate medical program and the nature
of the profession, it is expected that students quickly become independent learners and learn to manage
their time and responsibilities while effectively completing the workload. It is also the expectation and
responsibility of each student to learn to problem solve, ask questions, and handle others with maturity
and respect.

The Core Rotations are listed below:

     1.   Family Practice
     2.   Internal Medicine
     3.   Pediatrics
     4.   Women’s Health
     5.   Emergency Medicine
     6.   Surgery
     7.   Community Medicine
     8.   General Elective

All core rotations are approximately 5-1/2 weeks in duration. The sites and dates are scheduled by the
Clinical Coordinator. The General Elective Rotation is based on availability by the program, though the
final preceptorship may be chosen with the Clinical Coordinator’s help by students who are in good
standing with the program.

Students cannot switch or change clinical assignments without permission from the Clinical Coordinator.

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2020 2021 Towson University CCBC Essex
What to Expect From Clinical Rotations
The core of a Physician Assistant's education are the clinical rotations, where students become adept at
interacting with patients, didactic learning is applied, and new skills are practiced. After completing a
few rotations, it will become apparent that there is no such thing as a typical rotation or a standard
approach. Schedules and plans change, and personality conflicts arise, therefore students must develop a
high degree of flexibility and initiative to benefit fully from each rotation. It is to your benefit to learn as
much about being a Physician Assistant in each rotation, including not only the medical knowledge
obtained but also the relationships, interactions, and time management that each preceptor demonstrates.
Your role is part of an interprofessional team for patient care.

Objectives
The PA program wants your clinical rotations to be both educational and interesting. You are expected to
maintain professional conduct and demeanor at all times. Each rotation specialty has a directed set of
objectives, which are met through observation and participation at the clinical site and by attending
conferences and seminars with the preceptor. Students are responsible for independent reading and study
for any topic area that cannot be covered on the clinical site. Students are referred to the PA Program
required text list for independent reading and study, which is Access Medicine.

Description of Sites
The clinical practicum focuses on the assessment and overall management of patients presenting to the
clinical site. Students participate in all aspects of patient care including taking a thorough history,
performing a complete and a focused physical exam, developing differential diagnoses and implementing
treatment plans in collaboration with the preceptor.

Students will be exposed to both outpatient and inpatient settings. Every clinical site is different with each
preceptor having their own schedule which students are expected to adhere to. Each has its own inherent
assets and liabilities. Clinical sites within the same specialty vary. Some sites are highly structured with
a heavy patient load and limited student/preceptor conference time, while others may have a low patient
turnover rate with a lot of time for one-on-one instruction from the preceptor. Due to these variations, it
will be up to the student to glean the maximum from each rotation and to supplement what cannot be met
clinically with readings based on the objectives for that rotation.

Preceptors
Only one preceptor listed on the evaluation form is responsible for monitoring the student’s performance
during the rotation. The student may be placed with a single preceptor or part of a team. The lead preceptor
will consult with clinicians who had the most contact with the student to determine the final grade.

The instruction style of the preceptor is, quite possibly, the most variable feature of the clinical rotation.
Some preceptors have precious little time to spend with students one-on-one, and students are expected to
become a part of the interpersonal team. Remember each preceptor comes with their own personality and
expectations. Flexibility and maturity are essential as well as adapting to your varying surroundings.

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2020 2021 Towson University CCBC Essex
Schedule

When the student was accepted into this program, it was emphasized that the demands of the program
would require the student’s full attention during its 26 months. This means personal, financial or any
other considerations, should have been as well organized as possible to allow the student to focus on the
necessities of the program. With the numerous aspects of scheduling clinical rotations, it is not possible
for the student to choose which clinical site to attend. Preferences may be accommodated where possible.
The final decision on student placement rests with the Clinical Coordinator.

Students are strongly discouraged from seeking or continuing employment of any kind while enrolled in
our program. However, if a PA student chooses to work during this time, it is their responsibility to ensure
their employment does not interfere or conflict with any aspect of this program. This includes class
attendance, clinical rotations (including distance of clinical sites) and/or academic progress. Program
expectations, assignments, exams, or any other student responsibility will not be changed or adjusted in
any way to accommodate a student’s work environment.

On-Site Faculty Evaluation

Site visits serve several purposes. The preceptor can be kept abreast of program changes or schedule
modifications. The site and preceptor are evaluated against program standards. Student performance is
evaluated. Site visits are also intended to keep the student in touch with the program over the course of
the rotation. A minimum of 2 site visits (with a goal of up to 4) will be conducted per student throughout
the clinical year.

Assessment of the student’s performance during an on-site evaluation may include any or all the
following: review of chart entries, case presentation, and observation of interaction with staff and/or
patients.

The student will be contacted by a faculty member to schedule a time for the On-Site Evaluation. The
student must confirm this time with the preceptor and ensure the preceptor will be available as well.

                                   Student Responsibilities

Starting a New Rotation

Students are advised to contact their preceptor 3 weeks in advance of their upcoming rotation (please see
Preceptor Contact List.) When starting a new rotation, it is best to take a day to observe the style of patient
care and learn the routine of that particular site and preceptor. Observe and ask questions. How are patient
medical records and other data recorded? Who co-signs notes and orders? Who is in charge? How are
patients followed in the system? Open communication with the preceptor will ensure a successful
experience. Some rotations will have very specific requirements, while others may not be as structured or
have a predictable routine. The clinical year requires students to demonstrate their ability to observe,
communicate, and hone their clinical skills as well as their professionalism.

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2020 2021 Towson University CCBC Essex
Attitude

The amount of knowledge and expertise gained from each rotation is largely determined by the student’s
attitude and behavior. If a student chooses a passive role, the learning experience will be minimal. If,
however, a polite assertive stance is taken, the opportunity for learning is limitless. Therefore, it is
essential that students take initiative on each rotation. Preceptors and staff will evaluate how eagerly you
approach tasks on rotation.

There are always things to learn from different people in different professions. This is especially true in
the medical field, whether a student or a practicing professional. The student must make the preceptor
and other colleagues aware of whom they are and that they are willing to learn from every situation.
It is not only necessary, but also extremely beneficial to make every attempt to maintain an attitude of
mutual respect for all colleagues and accept all they have to offer. It is also imperative that you sharpen
your interpersonal skills to interact positively and competently with people of all social, cultural, religious,
ethnic, and socioeconomic levels.

Representation

*It is imperative that students represent themselves accurately as Physician Assistant students while in
the clinical setting, regardless of former title—RN, MD, PhD, PharmD, etc.

Physician Assistant students must be clearly identified as such. At minimum, students must wear an
identification badge at all times on site and introduce themselves to patients and hospital personnel
as a Physician Assistant student. Students who work in a health care capacity must dress appropriately
so as not to confuse or misrepresent their work role with their PA student status (i.e., the name badge and
program emblem may not be worn unless the student is completing a program clinical assignment).

Dress Code
Dress Code for clinical rotations is business casual; tasteful and appropriate as deemed by the program
(not too short or low cut, etc.) and/or the preceptor and site. Lab coats and clean, closed-toe shoes must
be worn. Jewelry should not be oversized or excessive. NO scrubs unless instructed by the preceptor
prior to reporting to the site. NO sandals, jeans, leggings, tight-fitting clothing, cargo shorts or t-
shirts.

Clinical supervisors, preceptors and faculty reserve the right to address any student who is inappropriately
or unprofessionally dressed. Program standards must be met in the classroom as well as in rotations. If
these expectations are not met, the student may be asked to leave their rotation and appropriate action will
be taken.

Attendance

Students are required to attend the site during the hours assigned by the preceptor and meet the
program’s required minimum 40 hours per week. This may include evenings, nights, weekends, and
some holidays. Promptness, readiness, and enthusiasm are reflected in each student’s final evaluation.
Students are expected to stay on site until all assigned work has been completed and the student is
dismissed by the preceptor. Students will not create their own work schedule to present to their preceptors.
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Under no circumstances, are students allowed to sleep while at clinical rotations, unless student is
scheduled to be on call overnight. This will be grounds for dismissal.

Absences
An absence from the clinical site, without proper notification to the Preceptor (via phone) AND the
Clinical Coordinator (via email), or failure to complete a Student Absence or Leave Request Form
before the end of the rotation will constitute an unexcused absence and result in failure of that rotation.
The Clinical Coordinator and the preceptor must be notified immediately, by both phone and email,
when absences for personal emergencies arise. The Clinical Coordinator will not notify the clinical site
of the absence for the student. Email or messages from another student will not suffice.
A student Absence Form must be signed by the preceptor and returned to the Clinical Coordinator no
later than the first class day after the rotation ends (See Appendix). It is the student’s responsibility to
arrange make-up time with the preceptor.
If the student is aware that a future absence will be necessary, a student Absence Form must be completed
and given to the Clinical Coordinator for approval at least 4 weeks in advance. (See Appendix)

Religious Holidays
Absences will be approved, provided that the preceptor and Clinical Coordinator are notified in advance
and clinical time is made up.

Illness
Any student who is ill and is likely to be contagious should not report to a clinical rotation in order to
protect the preceptor, staff, and patients. As stated above, it is the student’s responsibility to notify the
site and the Clinical Coordinator, by both email and phone immediately. The student will need to obtain
a doctor’s note to turn in to the Clinical Coordinator, and the missed time must be made up. A Student
Absence Form (See Appendix) must be signed by the preceptor and returned to the Clinical Coordinator
no later than the first class day after the rotation ends.

Inclement Weather Policy
Students are not required to attend the clinical site on days when CCBC Essex and/or Towson University
is closed due to inclement weather. However, it is strongly recommended that the student attend the site
if the commute can be made safely.
If the student is unable to report to the site due to inclement weather, the preceptor AND the Clinical
Coordinator are to be notified immediately, by office phone and email, plus a Student Absence form must
be returned to the Clinical Coordinator before the end of the rotation.

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Professional Conduct
Exemplary professional conduct is expected of all Physician Assistant students at all times. With this
as a fundamental principle, the PA Program will not tolerate violations of ethical or moral values, such as
cheating, plagiarism or unprofessional conduct. The PA student role requires that students be reliable and
competent, exercise sound judgment and act with a high degree of personal integrity at all times. When
problems arise at the clinical site which cannot be addressed immediately by the preceptor, the Clinical
Coordinator is to be notified of the incident immediately via email or telephone.

Further information:
*American Academy of Physician Assistants (AAPA) Guidelines for Ethical conduct: https://www.aapa.org

          Unprofessional behavior includes, but is not limited to the following:
     ·   Disobedience of or inappropriate challenge of orders or assignments from faculty,
         administrators, preceptors, or clinical supervising staff
     ·   Disrespect for or insensitivity to a patient’s rights, privacy, and privileges (i.e., HIPPA violation)
     ·   Failure to acknowledge or accept corrections or criticism and/or hostile or belligerent responses
         or comments to the correction
     ·   Failure to follow the site’s rules and regulations and chain of command
     ·   Failure to communicate with clinical supervisors (MD, DO, PA, NP, etc.) to whom they have
         been assigned
     ·   Assumption of sole responsibility of patient’s care without discussion with proper preceptors or
         other providers (i.e., pharmaceutical treatment, discharge, testing)
     ·   Observation or performance of procedures not authorized by the clinical institution and/or
         preceptor
     ·   Failure to demonstrate a respectful attitude to peers, instructors, or other members of the health
         care team
     ·   Unreliable, undependable behavior at clinical site
     ·   Leaving the clinical site until all work has been completed and/or the preceptor approves
     ·   Failure to cooperate with preceptor, group, or team efforts
     ·   Failure to deliver care without regard to race, ethnicity, age, sex, creed, religion, socioeconomic
         status, sexual orientation, national origin, and/or nature of medical/health care problem(s)
     ·   Uncontrolled or disruptive behavior on site or campus
     ·   Reluctance to participate in standard medical procedures or failure to perform clinical procedures
         in an acceptable manner
     ·   Failure to implement Universal Safety Precautions
     ·   Physical, verbal, or sexual harassment of anyone (patients, instructors, peers, or faculty)
     ·   Performance of any duties (including class attendance) while under the influence of alcohol or
         illegal substances or while taking prescribed medications which can cause impairment of
         behavior, level of alertness or motor skills
     ·   Any violation of academic integrity (plagiarism, copying another student’s work, sharing
         answers, using notes, phones or the internet during exams unless given specific permission) or
         violation of the program’s clinical polices or the School of Health Professions’ Code of Conduct
     ·   Any other incident/behavior, not listed above, deemed inappropriate by the program

                                                      6
Confidentiality

      ·   Patients’ rights to confidentiality and privacy must be adhered to at all times.
      ·   Posting anything on social media regarding classmates, faculty, preceptors, and academic or
          clinical sites is forbidden. This includes but not limited to Facebook, Twitter, Snapchat,
          Instagram, YouTube, or any other social media platform. Violation of this may result in dismissal
          from the program.
      ·   Use of ANY electronic device is strictly prohibited during any clinical rotation unless given
          specific permission by the preceptor.
      ·   Video recording, taping and photographs are prohibited in clinical site rotations.

 *All of the above are violations of the standards and polices of this program and this profession per
   HIPAA guidelines. The level of professionalism will be evaluated throughout the program and
 specifically during the clinical year. Any violation is to be reported to the Clinical Coordinator and
                                       may be cause for dismissal.

Problems
Invariably, problems arise during rotations. It is up to the student to clarify with the preceptor at the
outset of the rotation what the expectations are, eliminating unexpected surprises at the end of the
rotation. The mid-rotation evaluation is another tool used to measure progress. (See Appendix)

Personality conflicts do occur and students may feel awkward if one arises, particularly with the person
responsible for their grade. Maturity, sensitivity, intellectual ability, and professionalism are necessary in
any setting. Adaptability to mental, physical and emotional stress is essential to your clinical experience
and this profession. Always retain the highest level of integrity and compassion. Students will be
expected to accept direction and criticism and respond or modify their behavior to our standards. It is
crucial to identify difficulties as early as possible so as not to interfere with the student’s ability to learn
or jeopardize a fair assessment of the student’s performance. The student should contact the Clinical
Coordinator, their Faculty Advisor, or their Faculty Session Advisor as soon as a problem develops
in an attempt to lessen, if not solve the issue. All efforts will be made to reach a conclusion that is mutually
satisfactory to both the student and the preceptor.

Should a situation arise in which the student is requested to do something that he or she is
uncomfortable doing, without direct supervision, the student must inform the preceptor and not
perform the task until supervision is provided. Due to the unique nature and characteristics of
healthcare educational programs, whenever a conflict arises, our PA program policies take
precedence.

Standards of Conduct
      ·   Respect, sensitivity, comfort, and dignity to others regardless of age, gender, race, culture,
          religion, or disability
      ·   Behavior (i.e., tact and self-control; appropriate boundaries, cooperation, flexibility)
      ·   Professionalism in your manner, dress, grooming, speech, and social skills that is consistent with
          the program and this profession
      ·   Students are expected to introduce themselves and state they are a student in the PA program

                                                       7
·   Student ID badge (school badge or the facility) must be in view
     ·   Students must wear short white lab coat with the Physician Assistant Program’s logo at all times
         (unless given permission otherwise, i.e., in OR)
     ·   Stethoscope and pocket manual available at all times

The program expects all students to adhere to standards of professional conduct and patient safety.
Students failing to do so, at any time, will be removed from the clinical site and are subject to program
dismissal. Behaviors which will lead to immediate dismissal, include, but are not limited to:

     ·   Performing at an unsafe level as assessed by the clinical staff or Program Faculty
     ·   Unprofessional conduct
     ·   Unsatisfactory on the End-of-Rotation Evaluation
     ·   Failure to recognize one’s clinical limitations
     ·   Falsification of medical information, plagiarism
     ·   Misrepresentation of the student’s status

Probation
Program probation is the student’s notification that there is significant danger of program dismissal for
academic or professional conduct reasons. It is imperative that students on probation comply with all
recommendations made by the course instructor, advisor, and/or the Program Director. Students must be
in good standing with the requirements for CCBC and Towson University while on probation with the PA
Program. Formal documentation of all program probations becomes part of the student’s permanent file.
Students on program probation (academic, clinical, or professional) forfeit the following privileges
until returned to good standing:

     ·   Selection of final preceptorship
     ·   Selection of elective rotation
     ·   Participation on the Program’s Advisory Committee
     ·   Participation as a class/program leader or representative
     ·   Excused class or clinical absences to attend conferences/program extra-curricular activities.

Academic and Clinical Dismissal
The PA Program Director may dismiss students from the program in consultation with SPRC and other
concerned parties if a student fails to meet the requirements for successful program completion. Cause
for academic dismissal includes, but is not limited to:
      · More than one “C” course grades for Towson University PA courses
      · More than one “C” course grades for CCBC Essex PA courses
      · GPA for either Towson or CCBC courses falls below the level where it is not mathematically
         possible to earn a final 3.0 GPA
      · Serious breaches of academic or professional conduct that could have potentially endangered
         patient care or safety of patients, clinical personnel, instructors, or fellow students
      · Repeated “less serious violations”
      · Failure to follow curriculum or any directives from the program or clinical faculty
                                                    8
·   Recommendation by the core faculty that student performance or professional conduct indicates
         the student is unable to perform adequately and safely as a PA
     ·   Failure of any Year I course or failure to meet the requirements to advance to Year II
     ·   Failure of a Year II course or failure to meet the requirements for progression to the primary care
         preceptorship
     ·   Receipt of three or more written warnings
     ·   Dismissal from any clinical site due to documented misconduct and unprofessional behavior
     ·   Receiving an “Unsatisfactory” on the final rotation evaluation
     ·   Failure to pass the repeated/retested Fall and/or Spring OSCEs with an overall grade of 75%

Remediation
The goals of formal program remediation are:
     · To assure that the student has mastered the requisite knowledge
     · To reassess the students’ ability to perform at a satisfactory level and continue in the program
     · Determining a plan of action
     · Remedial exercises and/or tutoring
     · Demonstrated mastery of the material through a predetermined testing method with a
         predetermined mastery level

Students who have performed poorly on a major test, assignment, or examination whether practical or
written may be allowed to remediate the particular section or skill. The offer to remediate is determined
by the instructor or course coordinator in conjunction with the student. It is offered once during a course
as the result of a failing performance (less than a “C” grade) on a single test or assignment.

Successful remediation as determined by the course instructor and/or Clinical Coordinator and
remediation plan results in a passing grade (70% or above) for the course or component and in student
retention if all other program requirements are met. All remediation efforts remain documented in the
student’s permanent file.

Deceleration
Students who are unsuccessful with remediation plans or who are performing at a substandard level in one
or more areas of the didactic program (Year I courses and PAST 730/731) may be offered deceleration on
the recommendation of the Student Progress Review Committee.
Deceleration guidelines are not limited to:
      · Deceleration in Year I requires that the student restarts the program with the next class: repeating
         any course where a “C” or lower was earned and auditing all courses for which grades of “A” or
         “B” were earned. Graduation is delayed until all course requirements are met.
      · Deceleration in Year II requires that any course mentioned above where a “C” or lower was
         earned is repeated with a minimum of a “B.” This may require suspension of participation in
         clinical courses until didactic course work is successfully completed. Graduation is delayed until
         all course requirements are met. Please see the Student Clinical Manual.
      · Students granted a program leave of absence for medical purposes, military service, etc., may be
         decelerated if proper application is made through the SPRC. SPRC review and a
         recommendation for approval to the Program Director is required for PA Program sanctioned
         deceleration.
                                                     9
Academic Dismissal
The PA Program Director may dismiss students from the program in consultation with SPRC and other
concerned parties if a student fails to meet the requirements for successful program completion.

Cause for academic dismissal includes but is not limited to:
    · More than two “C” course grades for Towson University PA courses
    · More than two “C” course grades for CCBC Essex PA courses
    · GPA for either Towson or CCBC courses falls below the level where it is not mathematically
        possible to earn a final 3.0 GPA
    · Serious breaches of academic or professional conduct that could have potentially endangered
        patient care or safety of patients, clinical personnel, instructors, or fellow students
    · Repeated “less serious violations”
    · Failure to follow curriculum or any directives from the program or clinical faculty
    · Recommendation by the core faculty that student performance or professional conduct indicates
        the student is unable to perform adequately and safely as a PA
    · Receipt of three or more written warnings
    · Failure of any Year I course or failure to meet the requirements to advance to Year II
    · Failure of any Year II course or failure to meet the requirements for progression to the final
        preceptorship

Professional Conduct (Disciplinary) Dismissal

Most often breaches in professional conduct result in failure of the course during which they occur. Cause
for professional conduct dismissal occurring related to a course or outside of coursework includes but is
not limited to:

     ·   Serious breaches of classroom or professional conduct that could have potentially endangered
         patient care or safety of patients, clinical personnel, instructors, or fellow students
     ·   Repeated less serious violations
     ·   Falsification of any program or clinical documents
     ·   Failure to follow professional conduct directives from the program/clinical faculty
     ·   Recommendation by the core faculty that student performance or professional conduct indicates
         the student is unable to perform adequately and safely as a PA
     ·   Receipt of three or more professional conduct written warnings and breaches of professional
         conduct not listed here
     ·   Discovery at any time over the course of the program of falsification, misrepresentation, or
         omission of any requested information on any application materials submitted to CASPA, the
         PA Program, CCBC, or Towson University
     ·   Impairment due to substance abuse

                                                   10
Professional Conduct (Disciplinary) Dismissal Procedures

     1. Disciplinary problems or breaches in professional conduct will initially be discussed between
        the Program Director, involved faculty member, and the student.

     2. The Program Director will refer the issue to the appropriate committee or panel (e.g. SHP Honor
        Council, SPRC, etc.) The committee panel will hear complaints against the student and interview
        parties involved to make a final determination of disciplinary action based on PA Program
        Policies and Guidelines. The committee’s recommendations are forwarded to the Program
        Director. The Program Director will notify the student of the committee’s recommendations.

     3. Should the student disagree with the decision of the Program Director/referred committees that
        grounds for dismissal are met or feel that program policy has been unfairly applied, she or he
        may take the matter to the School of Health Professions Appeals Committee. The appeal process
        must be initiated within five business days of notification of the action. Information and appeals
        forms are available from the secretary to the Dean of the School of Health Professions.

     4. Violations of Towson University policy will be referred to the University disciplinary committee.

     5. Honor code violations are referred to the SHP honor code panel. This will be discussed at the
        SHP orientation.

     6. Violations of other CCBC policies may be referred to the Dean of School of Health Professions.
        This will be discussed at the SHP orientation.

                                  Rotation Requirements
Required Immunizations and Health Screenings

All students must be up to date with MMR, Hepatitis B, Varicella, and Tetanus. Flu immunization and
TB testing (PPD) must have been done within 1 year prior to the first rotation’s start date.

     ·    Annual PPD and Flu shot
          (Must be completed and handed into the program by October 15th)

In some cases, Hepatitis C vaccine information may also be requested by the preceptor or clinical site.

Further information:

     ·   Immunization of Health-Care Workers: Recommendations of the Advisory Committee on
         Immunization Practices (ACIP) and the Hospital Infection Control Practices Advisory C
         committee (HICPAC): http://www.cdc.gov/mmwr/preview/mmwrhtml/00050577.htm
     ·   Exposure    to    Blood:    What     Health   Care    personnel  needs     to   know:
         http://www.cdc.gov/ncidod/dhqp/pdf/bbp/Exp_to_Blood.pdf

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Site-Specific Paperwork

Many of our sites/ facilities and hospitals require their own documentation, learning modules and
paperwork specific to that site. All paperwork provided needs to be completed and turned in before
clinical rotation begins. Failure to comply will result in a delay in the start of your rotation schedule
and may ultimately affect your graduation date. This paperwork may seem redundant, but it is
crucial to our professional and legal relationship with our preceptors/sites.

Personal Health Insurance Coverage/ Liability Insurance/Drug Screenings

Students are required to carry personal health care insurance while attending the program and must provide
the program with verification of coverage before beginnning the program. Allowing health insurance
coverage to lapse at any time while in the program will result in immediate removal of the student from
clincial site or classes and may ultimately result in program dismissal. Neither CCBC nor the PA
program’s clinical affiliates provide health services to students beyond routine first-aid care. Some health
care services are available from the Towson University Health Center. Students may go to the health care
provider of their choice. This includes medical care for accidents or injuries which may occur on campus
or at any of the college's affiliated institutions.

Proof of liability insurance, background check and drug screening (annual renewal) are required for the
clinical year. Therefore, ALL students must renew these documents to continue on rotations. There is also
a possibility of random on site drug screens which would be at the descretion of the site/preceptor and the
procedures in place during that particular rotation. Students are responsible for all medical/
documentation fees incurred while attending the PA Program.

Safety and Security
Students, Faculty, and Clinical Faculty are responsible to ensure that appropriate security and personal
safety measures are addressed in all locations where instruction occurs. It is everyone’s responsibility to
read and observe policies on safety and security for each and every institution that you are assigned or
enter. All sites used by the program are safe, but should any site practices be concerning to the student,
the program should be notified immediately.

   *Weapons of any kind are prohibited from being carried by our students. This includes firearms
   of any kind, knives of any size, chemical sprays or anything that could be identified as a weapon.

Injuries to Students on Clinical Site or Campus
Should a student be injured (needle stick, fall, etc.) on site, an Incident Report, completed by the student,
needs to be filed with both the site and with the program. The program highly recommends that the
injured student seek medical assessment immediately.

All Physician Assistant students are required throughout the program, to have, carry, and maintain
personal health insurance. Neither CCBC, Towson University nor Clinical Rotations are responsible for
providing care for injuries sustained on campus or on rotation, beyond initial first aid treatment. The
injuries of greatest concern (other than those which are life threatening) are those associated with blood
borne pathogens, sustained by needle sticks and other sharps or through splashes of contaminated body
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fluids into open wounds or exposed mucosal membranes. The following are program requirements and
protocols to assure that appropriate steps are taken to minimize any long-term effect of such accidental
injuries.

     1.   Students must review blood borne pathogen protocols prior to starting each clinical rotation and
          receive a certificate of completion for Learning Harbor.
     2.   Students must carry with them (perhaps on the backs of their ID cards) these protocols.
     3.   Students must carry their medical insurance cards or papers identifying their insurance
          providers and preferably the name of their personal physician.
     4.   When an injury occurs on clinical site, the office manager, preceptor, and or clinic supervisor
          needs to be notified IMMEDIATELY.
     5.   When injury occurs on clinical site, the students must initiate treatments protocols already in
          place at that facility.
     6.   Incidence reports are to be filed with the clinical site AND with the PA program. These should
          be reasonably detailed as indicated on the form.
     7.   Some institutions have protocols that are initiated on site, when this is the case, follow the
          clinical site protocol and then according to instructions provided by the on-site provider, care
          may be then transferred to your personal medical provider.
     8.   When there is no medical care provided or available at the clinical site the student must go
          immediately to the patient’s nearest medical provider or the EMERGENCY DEPARTMENT.
     9.   Once care has been initiated by a medical provider or ED, a report needs to be sent to the PA
          Program. This report does not have to state the type of care provided nor does it have to state
          the diagnosis. The PA Program requires documented proof that the injury has been evaluated
          by a medical provider and therapy initiated.
     10. If the students has missed either clinical time or classroom time because of the injury, a third
         document must be provided to the Program which states that the students has been discharged
         from medical care and may safely return to the clinical site and classes.
     11. Students must make up all the clinical time lost due to injury and treatment, however, every
         effort will be made by the program to assure that the clinical time lost will be made up in an
         efficient manner so as to allow the student to complete the program as close to on time as
         possible.
     12. Students are responsible for the cost of this medical care, and they are required to seek
         appropriate care in a timely manner. If the injured student accepts medical care offered at the
         institution where the incident occurs, the student will be responsible for any charges or care that
         may be accessed. Once the student’s injury is acutely addressed, students must notify the
         Clinical Coordinator or Program Director by telephone or email of the incident as soon as
         possible, no later than 24 hours after the incident. The student must file an Incident Report (see
         Addendum) no later than the next business day.

Drug Screen, Alcohol Testing, and Background Check
Program clinical site may require routine drug and alcohol screening based upon student inappropriate
behavior in the clinical setting. Students required by a clinical setting to undergo screening or testing who
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test positive for drugs or alcohol are subject to dismissal from the program. Expense of any drug or alcohol
testing is the responsibility of the student. Dismissal from the Program will occur if the student refuses to
comply with the required drug and alcohol testing. Towson University and CCBC substance abuse
policies can be found in the Addendum.

Standard Precautionary Procedures
All standard precautions apply to labs, skills training and clinical experience as they protect the heathcare
professional as well as, the patients.

       Standard Universal Health Care Practices include:
       · Hand hygeine; cough and respiratory hygeine
       · Needle and bodily fluid safety practices
       · Wearing protective equipment (i.e., gloves, masks,eyewear and gowns)
       · Handling contaminated objects, equipment or surfaces

In summary:
     1.   Review blood borne pathogen protocols prior to each rotation
     2.   Contact the clinic head (follow the guidelines if they exist)
     3.   Initiate treatments immediately at your PMP or ED
     4.   Provide injury reports to clinical site and to PA Program
     5.   Provide treatment reports to PA program, if necessary
     6.   Provide discharge form to return to school to the program

                        Graduation Eligibility /Requirements
Students will not be able to progress or graduate until all the documentation and all the clinical
requirements have been met to the satisfaction of the Clinical Coordinator. These will include preceptor
evaluations, all program defined data loggings, successfully passing fall and spring OSCE (Objective
Structured Clinical Examination) and completion of GAIT Training.

Students should be aware that the TU/CCBC PA Program can be accomplished within 26 months barring
any type of adverse event prohibiting the advancement of the student in his or her educational progress.
In the event that such an event was to occur, graduation of the student will be delayed by the amount of
time (days, weeks, semesters, etc.) but not to exceed a total period of longer than 36 months from the start
of the program. [An exception to this would be an interruption of the program for extended military
service.]
    · For clinical practicum courses, any professionalism issue brought to the attention of the clinical
        coordinator directly by e-mail, telecommunication, or in person will be considered cause for the
        student to repeat a given rotation immediately prior to the final practicum, in its entirety, delaying
        the graduation by a minimum of the length of rotation. The student, providing the preceptor has
        not failed the student on the final written preceptor evaluation, will receive a grade of C for the
        rotation (or course) and the ensuing repetition will have to payed for by the student with the grade
        replaced by the new grade.
            o The clinical coordinator will document the date and issues brought forth by the preceptor.
            o The clinical coordinator will investigate and document the claims of the incidents.
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o The clinical coordinator will determine whether another repeat rotation is in order.
            o The clinical coordinator will notify the student immediately of the decision to repeat the
               rotation with the associated delay in graduation.
            o If the Clinical Coordinator cannot determine the egregiousness of the complaint or need
               to repeat the rotation, the Clinical Excellence Committee will assist in adjudication.
            o The Clinical Coordinator has the sole authority to make this decision.
   ·    For academic and technical courses, a student’s progress can be delayed as well as graduation,
        based on their ability to complete or remediate academic or technical or professional behaviors.
        Students are referred to the section on professionalism, remediation, and program success in the
        student handbook for details regarding successful progression.

Chart Entry Signature
All clinical documents and chart entries must be signed with the students' full name followed by PA-SI
(Year I) or PA-SII (Year II and Graduating students). Please include this on your SOAP notes and CM
projects. Students who fail to identify themselves appropriately will be dismissed from the program.

Patient Encounter Logs

Students keep a record of each patient contact through the Typhon logging system. Typhon data should
be logged for EVERY patient with whom the student has contact. Students missing/short clinical hours
due preceptors’ absence, unexpected clinical site closure, clinical suspension due to the program and or
institution recommendations, students need to complete CME credit hours. One (1) CME credit equals
two (2) clinical contact hours.

            **All data logs must be completed/entered prior to your Final Preceptorship**
               All Typhon encounters need to be completed by the end of the rotation.
                        If it is not, the student will receive an incomplete grade.

       1. Patient Encounter Logs
          · In the Typhon log, all areas with red arrow are required information for EVERY clinical
              encounter.
          · Log encounters daily to prevent any mistakes (such as losing the patient information,
              forgetting about the patient, rushing at the end of the rotation).
          · Program defined patient data requirements and failure to meet these requirements can
              cause a delay in your final preceptorship and graduation eligibility (see below):
                      Clinical Life Span Experience Requirements
                      Infants = 0-12 months (min. 10 cases)
                      Children = 1-12 yrs. old (min. 10 cases)
                      Adolescents = 12-18 yrs. old (min. 10 cases)
                      Adults = 19-65 yrs. old (min. 10 cases)
                      Elders = over 65 yrs. old (min. 10 cases)
                      Women’s Health = (min. 10 pre-natal cases)
                      Pre-Op = (min. 10 cases)
                      Operative = (min. 10 cases)
                      Post-Op = (min. 10 cases)
                      Behavioral Medicine = (min. 40 non-substance abuse cases)

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2. Skills Log
        * Skills performed during a rotation and their frequencies are also maintained electronically
        through Typhon. This will be assessed through documentation of CPT codes.
     3. Time Log
        · This should reflect the hours spent on site by the student and any absences during the rotation
        · In Typhon choose
            o Other Logs and Reports, then
            o     My Time Log, then
            o     Add/Edit Daily Time Log
            o Complete the entire log as it pertains to the clinical day. Should be completed daily
        · Record any conferences attended
            o My Clinical Conference Log
     4. Print out the summary of the Patients Encountered, Skills and Time Logs. The preceptor must
        sign off on all logs

Student Evaluation of the Clinical Rotation
These evaluations, done at the end of each rotation, should include constructive criticism and offer
suggestions for solutions for issues raised.

An evaluation on the preceptor and clinical site will be completed by hardcopy and given upon
return to the campus. The hardcopy must be turned in with other materials no later than the second
campus day following the end of rotation. These evaluations are summarized for preceptors at the end
of each clinical year.

                        Rotation/Course Grade Computation
Students must pass all rotations. Failure of a rotation will require repeating the rotation,
and therefore may delay graduation. Students may also face dismissal from the program
depending on the circumstances surrounding the failure. Students are highly
recommended to meet face-to-face with preceptors as often as necessary, but at a
minimum twice (once for mid-rotation evaluation and once for end-of-rotation
evaluation) during a rotation.
Preceptor Evaluation
The Preceptor Evaluation constitutes the majority of the student grade for each rotation (60% max.)
Preceptors complete a standard evaluation form, assesses whether or not the student’s performance was
exceptional, satisfactory, needs improvement or was unsatisfactory. The evaluation also speaks to the
professional conduct of the student while on site. Preceptors are encouraged to comment on the student's
skills, areas where the student performed well, and provide constructive criticism for areas that may need
improvement.

Preceptors will file the evaluation electronically through Typhon. Under extenuating circumstances, the
preceptor may choose to complete the evaluation and return it to the program via fax or email.

Students are responsible for seeing that the evaluations are submitted no later than the first class day
after the end of the rotation.
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